Zusammenfassung
Hintergrund: Die Verwendung von weichen Linsenmaterialien, wie z. B. Silikon, findet zunehmend Verbreitung in der Kataraktchirurgie. Die Vorteile der Kleinschnittechniken in bezug auf den chirurgisch induzierten Astigmatismus sind gut dokumentiert. Silikonintraokularlinsen stellen die am längsten auf den Markt befindlichen faltbaren Linsen dar.
Material und Methoden: In dieser Studie haben wir Häufigkeit und Art von Komplikationen analysiert, die zur Explantation von 100 Silikonhinterkammerlinsen (HKL) geführt haben. Diese Linsen waren dem Center for IOL-Research zur Begutachtung zugesandt worden und wurden mittels Lichtmikroskopie und Elektronenmikroskopie untersucht. Die Ergebnisse wurden mit Daten explantierter PMMA-HKL aus der Datenbank des Centers verglichen.
Ergebnisse: Von den 100 Silikon-HKL waren 63 Linsen dreistückigen Designs mit Polypropylenschlaufen und 37 einstückige Designs, sog. „plate“-Linsen. Die häufigsten Explantationsgründe waren HKL-Dezentrierung (42%) und entzündliche Reaktionen (27,7%). Es ergab sich kein statistisch signifikanter Unterschied in der Häufigkeitsverteilung der Explantationsgründe für ein- und dreistücke Linsen (p > 0,1; χ2-Test). Silikonlinsen, die wegen entzündlicher Reaktionen explantiert wurden, hatten eine signifikant längere Implantationsdauer (19,2 ± 12,1 Monate) als Linsen, die wegen Dezentrierung entfernt wurden (9,19 ± 12,1 Monate) (p = 0,018; Varianzanalyse).
Schlußfolgerungen: Die Häufigkeit und Art der Explanationsgründe von Silikonintraokularlinsen entsprach dem Profil wie es auch von PMMA Linsen bekannt ist. Die Ergebnisse deuten darauf hin, daß eher operative Probleme als das HKL Material selbst für eine Vielzahl der Explantationen verantwortlich waren.
Summary
Background: The use of soft intraocular lens materials is gaining in popularity. The advantages of small incision techniques in terms of surgically induced astigmatism are well documented. Silicone posterior chamber intraocular lenses (PC-IOLs) have been on the market since the late 1980s.
Methods: We analyzed incidence and types of complications seen after implantation of silicone PC-IOLs. Data from the laboratory database were collected on 100 explanted silicone IOLs submitted to the Center for Intraocular Lens Research from 1986 to 1994. We compared these data to that obtained in previous studies with standard PMMA IOLs.
Results: Of the 100 IOLs, 63 were three-piece designs with polypropylene loops and 37 were one-piece plate lenses. The two most important reasons for explantation were IOL decentration (42,0%) and inflammation (27,7%). There was no significant difference in the reasons for explantations between one-piece and three-piece IOLs (p > 0,1). IOLs that had been removed due to inflammatory reactions had a significantly longer implant duration (19,2 ± 18,9 months) than lenses that were explanted because of decentration (9,19 ± 12,1 months) (p = 0,018).
Conclusions: The results presented here confirm clinical observations that there is no substantial difference between these IOLs and PMMA lenses in terms of complication rates. Our data suggest that clinical outcome is not so much dependent on the type of lens selected, but rather on the quality of surgery.
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Auffarth, G.U., Wilcox, M., Sims, J.C.R., McCabe, C., Wesendahl, T.A., Apple, D.J. (1995). Komplikationen von 100 explantierten Silikonhinterkammerlinsen. In: Rochels, R., Duncker, G., Hartmann, C. (eds) 9. Kongreß der Deutschsprachigen Gesellschaft für Intraokularlinsen Implantation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-93570-1_38
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DOI: https://doi.org/10.1007/978-3-642-93570-1_38
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